Individual provider Active NPI

Sherrie Denise Kneebone, N.P.

  • Family Nurse Practitioner
  • Fremont, CA
National Provider Identifier
1003906587
Registry record updated Apr 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
592295 Issued in CA
Practice address
2000 Mowry Ave
Fremont, CA 94538-1716
Phone
(510) 795-2004
Fax
(510) 742-9285
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 592295 CA Primary

Addresses

Primary practice location

2000 Mowry Ave
Fremont, CA 94538-1716

Mailing address

2500 Mowry Ave
Suite 100
Fremont, CA 94538-1605
Phone (510) 795-2004

Other identifiers 1

IdentifierTypeStateIssuer
CMM70999FMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040803000592 CA Practitioner - Nurse Practitioner 2365413440 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Township Medical Foundation CurrentSince Mar 28, 2016 Accepting new patients
Washington Township Medical Foundation CurrentSince Mar 28, 2016 Accepting new patients

Locations

39500 Fremont Blvd
Ste 100
Fremont, CA 94538
Phone (510) 248-1800

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

38719 Stivers St
Fremont, CA 94536
Phone (510) 745-8373

6236 Thornton Ave
Newark, CA 94560
Phone (510) 248-1860

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240185600000",
    "number": "1003906587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MOWRY AVE",
            "address_2": "SUITE 100",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381605",
            "telephone_number": "510-795-2004",
            "fax_number": "510-742-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MOWRY AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381716",
            "telephone_number": "510-795-2004",
            "fax_number": "510-742-9285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNEEBONE",
        "first_name": "SHERRIE",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2009-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "592295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMM70999F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.